Is My Loved One’s Nursing Home Safe?
By Craig Knapp on August 12, 2019

As attorneys who litigate nursing home neglect and assisted living facility abuse cases, we unfortunately know all too well the “red flags” to watch out for in determining whether a particular facility is likely to be safe. We have seen too often how these signs can quickly transition from troubling to tragic.

We find that the most common injuries or dangers that arise from the nursing home setting concern 1) falls; 2) wandering from the facility; and 3) choking.

We believe in the age-old maxim, “an ounce of prevention is worth a pound of cure.” Here, this means keeping an eye out for red flags and warning signs that your loved one’s nursing facility may not be safe, or that the level of care may be placing him/her in danger.

Unfortunately, many of us overlook opportunities to uncover “red flags” and other warning signs, so that we can timely intervene to keep our loved one safe. Sadly, we tend to do so only with the best of intentions. Read on to see what we mean.

Ensuring that the Nursing Facility is Caring for our Loved One Properly

Perhaps the best advice we can offer is: allow the nursing facility to care for your loved one in your presence, and as they ordinarily would as though you were not there. This is as opposed to trying to do everything yourself for your loved one, whenever you visit.

The benefits of allowing the nursing facility to care for your loved one, even when you are there with him/her, are twofold. 1) It allows you to spend quality time with your loved one, where you do not need to worry about taking care of him or her; rather, you can enjoy a deep conversation, watch a movie, or play a game without distraction; 2) It allows you the opportunity to be “a fly on the wall” and carefully observe how your loved one is being taken care of. For instance:

• Allow your loved one to use the call light. From this, you can watch and see how long it takes for caregivers to respond. Are they timely? Or is your elderly parent forced to wait longer than seems appropriate or safe? Ask your loved one if such a long wait time is normal, even when you aren’t visiting.
• Observe as caregivers transfer/move your parent from bed to a wheelchair and back. Are they careful? Are they kind? Are they gentle?
• Stand outside the bathroom as caregivers assist your parent during toileting. Is the caregiver impatient? Does the caregiver ever walk out of the bathroom? Why? Does your parent find him or herself on the toilet without assistance when he/she needs it?
• Let the caregivers feed your parent, if assistance in eating is needed. Observe their technique. Do they take their time by waiting for your loved one to fully chew and swallow? Or do they rush your parent along?
• Try to plan visits at different times of day, at least once in a while. This will allow you to meet staff members you wouldn’t have otherwise interacted with, and gauge their level of care. Every caregiver might treat your loved one differently. It is important that you witness a healthy mix of different staff, to get a better sense of the overall provision of care. A diversified visiting schedule also means that the staff cannot get away with only cleaning your parent up, or cleaning his/her room, in preparation for your visit. Rather, in order to avoid being caught unprepared, they have to do their job all the time. This is ultimately for everyone’s benefit.
• Be involved in the development of your loved one’s care plan, and provide input from your personal experience and knowledge of your loved one. While the nursing team is comprised of professionals, it is important to remain vigilant to the extent that the care plan they develop may overlook important health conditions or risk factors for your loved one. Ultimately, you know your loved one better than anyone working at the facility. While you may not be a medical expert, you are an expert when it comes to your loved one, and so your thoughtful and respectful input may be important.
• Review your loved one’s nursing facility charting/notes/records/incident reports. It is common to train nursing facility staff that, if something of significance is not written down in the patient chart, then it didn’t happen. So reviewing the chart has two benefits: 1) If you notice that important things about your loved one’s care are not also recorded in the records, this is a “red flag;” 2) Similarly, if there are important things about your loved one’s care in the records, but which were not communicated to you and you are your loved one’s contact/power of attorney, then this is also a “red flag.”
• If you See Something, Say Something.  If you see something being done that seems wrong, unsafe, or inappropriate, do not hesitate to politely and respectfully speak up. As long as you engage with nursing facility staff in a kind, calm, and thoughtful manner, you should never fear asking important questions about your loved one’s care. Similarly, there is no harm in politely advocating for certain interventions or techniques that you know have worked in the past, or are likely to keep your loved one safe in the future.

Remember, you or your loved one is paying for these services. The nursing facility is the customer service provider, and you or your loved one is the customer. You therefore have every right to know what is happening with your loved one in the care of these professionals. Or, perhaps, what is not happening, which should be happening.